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  1. Artikel ; Online: Enfermedad vascular portosinusoidal: un cambio de paradigma.

    Téllez, Luis / Donate, Jesús / Albillos, Agustín

    Medicina clinica

    2024  Band 162, Heft 9, Seite(n) 439–447

    Abstract: The term portosinusoidal vascular disorder (PSVD) refers to a clinical-pathological entity that encompasses those patients with intrahepatic vascular damage without cirrhosis at risk of developing severe complications of portal hypertension. Numerous ... ...

    Titelübersetzung Portosinusoidal vascular disorder: A paradigm shift.
    Abstract The term portosinusoidal vascular disorder (PSVD) refers to a clinical-pathological entity that encompasses those patients with intrahepatic vascular damage without cirrhosis at risk of developing severe complications of portal hypertension. Numerous systemic diseases, genetic disorders, and toxic agents have been associated with this pathology, making its diagnosis an important clinical challenge. The recent description of uniform diagnostic criteria and a better understanding of its pathophysiology will allow for better identification of patients, even in early stages of the disease. Although there is currently no effective etiological treatment available, early diagnosis allows for the development of preventive strategies for some severe complications of portal hypertension.
    Mesh-Begriff(e) Humans ; Hypertension, Portal/diagnosis ; Hypertension, Portal/etiology ; Hypertension, Portal/complications ; Hypertension, Portal/therapy ; Portal Vein ; Vascular Diseases/diagnosis ; Vascular Diseases/etiology
    Sprache Spanisch
    Erscheinungsdatum 2024-02-01
    Erscheinungsland Spain
    Dokumenttyp Journal Article ; Review
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2023.11.018
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: Strategic analysis and recommendations of the Sociedad Española de Patología Digestiva (SEPD) regarding population-based screening programs for colorectal cancer in Spain.

    Albillos, Agustín / Carballo, Fernando / Crespo, Javier

    Revista espanola de enfermedades digestivas

    2024  

    Abstract: Introduction: population-based screening programs are effective to reduce colorectal cancer-related mortality and incidence. However, given their complex development, sound organization and design do not warrant success. This study provides a strategic ... ...

    Abstract Introduction: population-based screening programs are effective to reduce colorectal cancer-related mortality and incidence. However, given their complex development, sound organization and design do not warrant success. This study provides a strategic analysis of the Spanish programs, as well as recommendations in an attempt to contribute to their optimization.
    Methods: a multidisciplinary panel of researchers, supported by the Sociedad Española de Patología Digestiva (SEPD), has performed a SWOT (strengths, weaknesses, opportunities and threats) analysis, from which a proposal of recommendations was developed; their adequacy was judged using an adapted version of the RAND/UCLA method.
    Results: 5 weaknesses, 3 threats, 5 strengths and 5 opportunities were identified, and a total of 15 recommendations were developed emphasizing aspects with room for improvement in program orientation, particularly the need to increase participation, fight variability and inequities, improve information processes and systems quality, ensure specific, adequate funding, and evaluate health results.
    Conclusion: promoting an operational collaboration framework between all the public health and care levels involved should facilitate effective communication with society regarding the benefits of taking part in population screening programs while persuading decision and policy makers of the critical importance of taking an active, determined stance regarding its implementation.
    Sprache Englisch
    Erscheinungsdatum 2024-05-20
    Erscheinungsland Spain
    Dokumenttyp Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2024.10458/2024
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  3. Artikel ; Online: Beta-blockers in the era of precision medicine in patients with cirrhosis.

    Albillos, Agustín / Krag, Aleksander

    Journal of hepatology

    2022  Band 78, Heft 4, Seite(n) 866–872

    Abstract: For decades, non-selective beta-blockers (NSBBs) have been the standard of care for the primary and secondary prevention of bleeding from oesophageal varices. However, several questions regarding the best clinical use of NSBBs remain unanswered and new ... ...

    Abstract For decades, non-selective beta-blockers (NSBBs) have been the standard of care for the primary and secondary prevention of bleeding from oesophageal varices. However, several questions regarding the best clinical use of NSBBs remain unanswered and new data continue to emerge. Herein, we aim to delineate the therapeutic window of NSBBs in cirrhosis from a more individualised perspective. We address the current controversy of widening the therapeutic window and prescribing NSBBs to all patients with clinically significant portal hypertension. Although transient elastography is useful to rule-in clinically significant portal hypertension, we lack robust data supporting the use of NSBBs in patients without varices. While most data are based on propranolol, accumulating evidence suggests that carvedilol is superior and should be the first-line treatment until the decompensated stage. The clinical risk-to-benefit ratio appears to deteriorate in advanced decompensated stages and the risk of harm is high in patients with refractory ascites, low blood pressure and renal impairment, which clinically define closure of the therapeutic window. We also critically review non-invasive surrogates and biomarkers for predicting the haemodynamic response to NSBBs and confirm that the absence of reliable non-invasive methods is one of the main challenges facing the field.
    Mesh-Begriff(e) Humans ; Precision Medicine ; Gastrointestinal Hemorrhage/prevention & control ; Adrenergic beta-Antagonists/therapeutic use ; Liver Cirrhosis/complications ; Liver Cirrhosis/drug therapy ; Hypertension, Portal/etiology ; Hypertension, Portal/complications ; Esophageal and Gastric Varices/drug therapy ; Esophageal and Gastric Varices/etiology
    Chemische Substanzen Adrenergic beta-Antagonists
    Sprache Englisch
    Erscheinungsdatum 2022-12-15
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2022.12.005
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  4. Artikel ; Online: Non-selective beta-blockers in patients with ascites: The complex interplay among the liver, kidney and heart.

    Téllez, Luis / Albillos, Agustín

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

    2022  Band 42, Heft 4, Seite(n) 749–761

    Abstract: Non-selective beta-blockers (NSBBs) are the cornerstone of the primary and secondary prophylaxis of variceal bleeding in cirrhotic patients. They additionally prevent ascites development and death in compensated patients with clinically significant ... ...

    Abstract Non-selective beta-blockers (NSBBs) are the cornerstone of the primary and secondary prophylaxis of variceal bleeding in cirrhotic patients. They additionally prevent ascites development and death in compensated patients with clinically significant portal hypertension. After ascites onset, NSBBs remain beneficial for preventing further decompensations. However, as the cirrhosis progresses, the inflammation increases, systemic vasodilatation worsens, ascites turns refractory and cardiodynamic equilibrium becomes extremely fragile. In this scenario, NSBBs can critically impair the cardiac reserve and facilitate a haemodynamic breakdown, imperilling renal perfusion. Consequently, NSBB treatment should be carefully monitored or even avoided in such patients, and other options for portal hypertension management should be considered. In the present review, we explore the effects of NSBBs in patients with ascites and discuss the complex interplay among their hepatic, systemic and renal haemodynamic effects in this scenario.
    Mesh-Begriff(e) Adrenergic beta-Antagonists/therapeutic use ; Ascites/complications ; Ascites/drug therapy ; Esophageal and Gastric Varices/complications ; Esophageal and Gastric Varices/drug therapy ; Gastrointestinal Hemorrhage/drug therapy ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/prevention & control ; Humans ; Kidney ; Liver Cirrhosis/complications ; Liver Cirrhosis/drug therapy
    Chemische Substanzen Adrenergic beta-Antagonists
    Sprache Englisch
    Erscheinungsdatum 2022-02-11
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15166
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: The shaping of gut immunity in cirrhosis.

    Muñoz, Leticia / Caparrós, Esther / Albillos, Agustín / Francés, Rubén

    Frontiers in immunology

    2023  Band 14, Seite(n) 1139554

    Abstract: Cirrhosis is the common end-stage of chronic liver diseases of different etiology. The altered bile acids metabolism in the cirrhotic liver and the increase in the blood-brain barrier permeability, along with the progressive dysbiosis of intestinal ... ...

    Abstract Cirrhosis is the common end-stage of chronic liver diseases of different etiology. The altered bile acids metabolism in the cirrhotic liver and the increase in the blood-brain barrier permeability, along with the progressive dysbiosis of intestinal microbiota, contribute to gut immunity changes, from compromised antimicrobial host defense to pro-inflammatory adaptive responses. In turn, these changes elicit a disruption in the epithelial and gut vascular barriers, promoting the increased access of potential pathogenic microbial antigens to portal circulation, further aggravating liver disease. After summarizing the key aspects of gut immunity during homeostasis, this review is intended to update the contribution of liver and brain metabolites in shaping the intestinal immune status and, in turn, to understand how the loss of homeostasis in the gut-associated lymphoid tissue, as present in cirrhosis, cooperates in the advanced chronic liver disease progression. Finally, several therapeutic approaches targeting the intestinal homeostasis in cirrhosis are discussed.
    Mesh-Begriff(e) Humans ; Intestines ; Liver Cirrhosis/pathology ; Intestinal Mucosa ; Liver Diseases/metabolism
    Sprache Englisch
    Erscheinungsdatum 2023-04-14
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2023.1139554
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel: Evolving portal hypertension through Baveno VII recommendations.

    Mendizabal, Manuel / Cançado, Guilherme Grossi Lopes / Albillos, Agustín

    Annals of hepatology

    2023  Band 29, Heft 1, Seite(n) 101180

    Abstract: The Baveno VII consensus workshop has provided several novel recommendations regarding the management of patients with clinically significant portal hypertension (CSPH). The expert panel summarized the existing data into simple clinical rules to aid ... ...

    Abstract The Baveno VII consensus workshop has provided several novel recommendations regarding the management of patients with clinically significant portal hypertension (CSPH). The expert panel summarized the existing data into simple clinical rules to aid clinicians in their clinical practice. The use of non-invasive tests (NITs), especially liver stiffness measurement (LSM), have gain an important role in daily practice. The use of LSM alone or in combination with platelet count can be used to rule-in and rule-out compensated advanced chronic liver disease (cACLD) and CSPH. Further decompensation events were defined as a prognostic stage associated with an even higher mortality than that associated with first decompensation. Moreover, the term hepatic recompensation was introduced in Baveno VII consensus implying a partial or complete regression of the functional and structural changes of cirrhosis after the removal of the underlying etiology. This review will summarize the reader main aspects of Baveno VII consensus regarding the use of NITs in cACLD, analyze further decompensation events, and evaluate recent recommendations for prophylaxis and management of liver decompensation events.
    Mesh-Begriff(e) Humans ; Esophageal and Gastric Varices/diagnosis ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/therapy ; Hypertension, Portal/complications ; Hypertension, Portal/diagnosis ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/therapy ; Prognosis ; Elasticity Imaging Techniques
    Sprache Englisch
    Erscheinungsdatum 2023-11-19
    Erscheinungsland Mexico
    Dokumenttyp Review ; Journal Article
    ZDB-ID 2188733-0
    ISSN 1665-2681
    ISSN 1665-2681
    DOI 10.1016/j.aohep.2023.101180
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Reply to: "Anticoagulation to prevent disease progression in patients with cirrhosis".

    Albillos, Agustín / Guerrero, Antonio / Téllez, Luis

    Journal of hepatology

    2023  Band 79, Heft 3, Seite(n) e125–e126

    Mesh-Begriff(e) Humans ; Liver Cirrhosis/complications ; Anticoagulants/adverse effects ; Blood Coagulation ; Disease Progression ; Portal Vein
    Chemische Substanzen Anticoagulants
    Sprache Englisch
    Erscheinungsdatum 2023-06-09
    Erscheinungsland Netherlands
    Dokumenttyp Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2023.05.040
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  8. Artikel ; Online: The Role of the Gut-Liver Axis in Metabolic Dysfunction-Associated Fatty Liver Disease.

    Martín-Mateos, Rosa / Albillos, Agustín

    Frontiers in immunology

    2021  Band 12, Seite(n) 660179

    Abstract: The complex interplay between the gut microbiota, the intestinal barrier, the immune system and the liver is strongly influenced by environmental and genetic factors that can disrupt the homeostasis leading to disease. Among the modulable factors, diet ... ...

    Abstract The complex interplay between the gut microbiota, the intestinal barrier, the immune system and the liver is strongly influenced by environmental and genetic factors that can disrupt the homeostasis leading to disease. Among the modulable factors, diet has been identified as a key regulator of microbiota composition in patients with metabolic syndrome and related diseases, including the metabolic dysfunction-associated fatty liver disease (MAFLD). The altered microbiota disrupts the intestinal barrier at different levels inducing functional and structural changes at the mucus lining, the intercellular junctions on the epithelial layer, or at the recently characterized vascular barrier. Barrier disruption leads to an increased gut permeability to bacteria and derived products which challenge the immune system and promote inflammation. All these alterations contribute to the pathogenesis of MAFLD, and thus, therapeutic approaches targeting the gut-liver-axis are increasingly being explored. In addition, the specific changes induced in the intestinal flora may allow to characterize distinctive microbial signatures for non-invasive diagnosis, severity stratification and disease monitoring.
    Mesh-Begriff(e) Animals ; CCR5 Receptor Antagonists/therapeutic use ; Dysbiosis/immunology ; Dysbiosis/microbiology ; Gastrointestinal Microbiome/immunology ; Humans ; Imidazoles/therapeutic use ; Intestinal Mucosa/immunology ; Intestinal Mucosa/metabolism ; Intestinal Mucosa/microbiology ; Liver/immunology ; Liver/metabolism ; Liver/pathology ; Metabolic Syndrome/drug therapy ; Metabolic Syndrome/immunology ; Metabolic Syndrome/metabolism ; Non-alcoholic Fatty Liver Disease/drug therapy ; Non-alcoholic Fatty Liver Disease/immunology ; Non-alcoholic Fatty Liver Disease/metabolism ; Sulfoxides/therapeutic use
    Chemische Substanzen CCR5 Receptor Antagonists ; Imidazoles ; Sulfoxides ; cenicriviroc (15C116UA4Y)
    Sprache Englisch
    Erscheinungsdatum 2021-04-16
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.660179
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  9. Artikel: Update on the diagnosis and management of portal hypertension in cirrhosis according to the Baveno VII Consensus Conference recommendations.

    Téllez, Luis / Guerrero, Antonio / Albillos, Agustín

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2022  Band 114, Heft 9, Seite(n) 534–542

    Abstract: Development of portal hypertension is the most critical hallmark in the natural history of advanced chronic liver disease, as it is responsible for most liver decompensations. Correct risk stratification allows the design of personalized treatment ... ...

    Abstract Development of portal hypertension is the most critical hallmark in the natural history of advanced chronic liver disease, as it is responsible for most liver decompensations. Correct risk stratification allows the design of personalized treatment strategies. In addition, the dynamic nature of chronic liver disease requires a refinement of both invasive and non-invasive diagnostic methods at every stage. Treatment with non-selective beta blockers and suppression of the etiologic factor improve portal hypertension and decrease the probability of decompensation in high-risk patients. Patients admitted for variceal hemorrhage also benefit from personalized management, where insertion of a preventive TIPS plays a relevant role.
    Mesh-Begriff(e) Adrenergic beta-Antagonists/therapeutic use ; Esophageal and Gastric Varices/diagnosis ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/therapy ; Gastrointestinal Hemorrhage/diagnosis ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Hypertension, Portal/complications ; Hypertension, Portal/diagnosis ; Liver Cirrhosis/complications
    Chemische Substanzen Adrenergic beta-Antagonists
    Sprache Englisch
    Erscheinungsdatum 2022-09-15
    Erscheinungsland Spain
    Dokumenttyp Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2022.8868/2022
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel: A novel EUS-guided rescue therapy for non-drainable walled-off pancreatic necrosis.

    Sánchez Aldehuelo, Rubén / Albillos, Agustin / Vazquez-Sequeiros, Enrique

    Gastroenterologia y hepatologia

    2021  Band 45 Suppl 1, Seite(n) 83–84

    Mesh-Begriff(e) Drainage ; Endosonography ; Humans ; Necrosis ; Pancreatitis, Acute Necrotizing/diagnostic imaging ; Pancreatitis, Acute Necrotizing/drug therapy ; Pancreatitis, Acute Necrotizing/surgery ; Stents ; Ultrasonography, Interventional
    Sprache Spanisch
    Erscheinungsdatum 2021-03-19
    Erscheinungsland Spain
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 632502-6
    ISSN 0210-5705
    ISSN 0210-5705
    DOI 10.1016/j.gastrohep.2021.01.015
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